Individual
DR. PREMILA MALHOTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
308 COLISEUM DR, SUITE 120, MACON, GA 31217-3865
(478) 745-6130
(478) 745-4443
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(478) 745-6130
(478) 745-4443
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
055279
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
594984700D
—
GA
05
—
594984700E
—
GA
05
—
594984700F
—
GA
Enumeration date
05/09/2007
Last updated
08/24/2020
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